For "vermillion border" or
lip edge.
Also to add volume & fullness to the body of the lip.
Duration
3 - 6 months - No allergy test required
Moderate to pronounced swelling ( may last 1 - 3 days )
Bruising a possibility
Advantages
Softer, rounder lip edge
Suitable for use in body of lips, to create volume enhancement.
Restylane - Lip
Augmentation
Before
After
New Fill (Polylactate gel)
For "vermillion border" or lip edge
Duration
12 - 18 months. - No allergy test required
Not recommended for those who have not had previous lip augmentation.
Moderate to significant swelling of lip area usually settles
by next day, but may last up to 3 days
Bruising a possibility
Massage VERY important for week following treatment to ensure
collagen grows evenly & smoothly along lip edge.
Removing Lip Creases
Most effective treatment is to
inject the lines directly, but an additional, secondary benefit
can be achieved by horizontally stretching the lip edge "bolster
pout".
COLLAGEN or RESTYLANE can be used to correct fine to moderate
lines, but due to it's fibrous nature collagen often gives
better correction & longevity in this high muscle stress
area.
If there is significant volume loss to this area NEWFILL
can also be used as a pre treatment to restore the depleted
collagen network, thereby increasing longevity of surface
collagen treatment.
BOTOX is very occasionally used as an addition in deep,
etched upper lip lines, but treatment of this area will incur
mild transitory weakness of upper lip area for up to 3 weeks.
Restylane - Perioral
Lines
Before
After
SKIN
Lip
Enhancement
Botox® (Botulin toxin) is a natural,
purified protein that relaxes wrinkle-causing muscles which
can make you look tired, older, stressed and angry. It can
make you look less tired, more youthful, relaxed and feel
better about yourself. Results can last up to six months.
Botox has been used in the medical profession
for nearly thirty years and is very safe and
universally accepted. It is used for both medical
and cosmetic treatments. Its muscle-relaxing
effects are beneficial for patients with uncontrolled
muscle spasms and twitches of the face (as occur
with certain neurological disorders), migraine
sufferers and even reducing excessive sweating
of the armpits (sweat glands have the similar
nerve receptors as muscles).
Cosmetically, Botox is most commonly used for eliminating
crease-lines around eyes (crows-feet), frown lines between
eyebrows and horizontal forehead lines. Additionally, it
is also used for other areas including brow shaping and
is an excellent addition to a facial rejuvenation program;
working
well with other modalities such as skin resurfacing
and intra-dermal fillers.
Wrinkles are eliminated by relaxing the underlying
muscle with a series of tiny injections passed through
the skin. It is equally effective for men and women. The
procedure only takes a few minutes to perform, with minimal
discomfort and is very well tolerated.
Most clients return to their daily activities immediately
after the treatment. At worst, there may occur some bruising
which can be covered with foundation or other types of
facial camouflage. Our staff may provide you with this
service if found necessary.
As with all treatments, the staff will discuss with
you any relevant potential complications. To avoid such an
event, only thoroughly trained and experienced practitioners
are permitted to provide such treatments at aussiesurgery.com
CHEMICAL PEEL
TCA Peel
Easy TCA peel can be used for various
problems such as discolouration and photo-ageing. Easy
TCA is made up of an acid solution and a cream to be applied
by your Doctor/nurse. The
cream relieves the slight burning
of the acid and contains active peeling ingredients including
vitamins, antioxidants, trace elements and other stimulating,
anti ageing, anti acne and lightening properties. For this
reason it must be left on the skin to act until the following
morning after your treatment.
After Your Treatment
Immediately after your peel you
will look frosty white. This is due to the chemical reaction
and will settle over the next hour or so. Generally most
people peel the 2nd or 3rd day, or you may not peel at
all. It is similar to a bad sunburn. Your skin may flake
off or it may come off in sheets. Some people experience
a brown discolouration. This is normal. Most people find
that they can still work and function as normal, but some
prefer to take a few days to recover from the peeling phase.
What Are Alpha-Hydroxy Acids (AHAs)?
AHAs are a class of compounds that
are derived from food sources, for example glycolic acid
is found in sugar cane. These AHA compounds have the unique
property to improve the skin.
Who Can Use Alpha-Hydroxy Acids?
AHAs can be used by men and women
of all ages and skin types. It can be used to treat skin
that is showing signs of aging, sun damage, non active
acne, or poor texture and appearance.
How Long Does It Take To Work?
Within 2 weeks the skin will look
and feel softer and smoother. After 4 weeks the skin tone
is more even and fine wrinkles will often reduce.
Are There Any Contradictions
To Use?
If you have been using Retin-A you must
discontinue it a week prior to the use of AHAs. If you
are allergic to milk, grapes, apples or citrus fruits,
treatment is not recommended.
Dermal Fillers
Age, environmental factors & muscle
stress all lead to a decrease in the skin's collagen support
structure and moisture balance.
This results in the development of fine lines, deeper wrinkles,
contour depressions and general loss of volume of the skin.
A variety of treatments can be used to fill out the lines,
plump up depressions & restore volume to the face,
giving a more youthful appearance & lessening the effects
of time.
There is no single treatment that is right for everybody.
The most appropriate treatment for you, depending on your
lifestyle, age & medical history will be discussed
in detail at your initial consultation. A fully atment
plan will then be offered for your consideration.
Bovine (beef) dermal collagen, highly
purified for injection
Collagen is one of the major components of our skin & is
responsible for its structure and support.
Collagen is a fibrous product which makes it particularly good
for areas under high muscle stress.
Zyderm 1
For fine surface lines, around eye area and for
those with very fine skin.
Zyderm 2
For moderate surface lines, areas of high muscle
stress and overlaying etched lines after Botox or Newfill.
Zyplast
Deeper lines, wrinkles, scars and lip enhancement.
Allergy Test
4 weeks prior to treatment (97% ok to proceed)
Treatments
Usually 2 treatments, 1 month apart. Then 1 treatment
every 4 to 6 months.
Treatment intervals often increase over time.
Discomfort
Usually mild (collagen contains local anaesthetic)
Local anaesthetic injection may also be used in some areas
Ice used prior to treatment to numb the area and reduce possibility
of bruising.
NASHA (Non Animal Stabilised Hyaluronic
Acid)
Its source is synthetic but Hyaluronic acid is one of the other
major components of skin responsible for moisture balance
Restylane is a clear gel
Restylane
For moderate wrinkles and lip enhancements
Perlane
For deeper folds and volume augmentation of lips
Allergy Test
Not required
Treatments
Usually 2 treatments 1 month apart then 1 treatment
every 4-8 months
Discomfort
Mild to moderate
Local anaesthetic injection may be used in some areas
No local anaesthetic contained in product, so more sensitive
than collagen
Ice used prior to treatment to numb the area and reduce possibility
of bruising.
After Treatment
Mild to moderate redness
Moderate swelling (may be pronounced if lips treated- can
last 1-3 days).
Occasional superficial bruising
Advantages
Immediate results
Enhanced shape and definition to lips
Restyline - Nasolabia
Depression And Lip
Before
After
Treatments To Volumes
Skin And Plump Up Depressions
New
Fill /Sculptra
Source
Poly-L-Lactic Acid.
Lactic acid is again a natural
component of our skin, Poly Lactic Acid acts to stimulate
our skins collagen production thereby, thickening and
volumising the skin.
It is the only product that 'plumps
up' thin skin and restores fullness to the face. Gradual
improvement is seen over 2 months
as collagen growth is stimulated.
Newfill/Sculptra is particularly
beneficial for loss of volume in the cheek area, nose to
mouth depressions, marionette depressions and general firming
of early stage looseness of skin.
Allergy Test
Not required.
Treatments
Usually from 2 for moderate depressions
Ranging to 5 for more widespread volumising of face
Then usually 1 treatment top-up every 12 - 18 months
Discomfort
Mild to moderate. (Newfill contains local anaesthetic
but is a deeper injection.)
Local anaesthetic injection may be used in addition in some
areas.
Ice used prior to treatment to numb area & reduce possibility
of bruising.
After Treatment
Mild to moderate redness
Mild to moderate swelling (greater volume of product injected)
Oral area - moderate to significant swelling (usually mostly
settled by next day, but may last up to 3 days).
Bruising a possibility.
Massage very important in initial week to ensure smooth &
even growth of collagen.
Advantages
Longer lasting correction. 12 to 18 months.
Natural, youthful looking result.
Slow, gradual improvement means no-one need know !
New Fill - Nasolabis
Depression - age 35
Before
After
New Fill - Marionette
Depression - age 52
Before
After
Fat
Transfer
This is a procedure, whereby a small
quantity of fat is removed from the buttock, thigh or abdomen
and injected into deep lines in the face. It is most commonly
used for the deep creases between the mouth and nose (naso-labial
folds) but can also be used to plump lips and depressed
scars.
The advantage of a fat transfer
procedure is that the fat is naturally occurring within
the body and therefore will not result in any untoward
reactions. It is particularly good for people who are allergic
to other injectables e.g. collagen, or who don't like the
idea of having a foreign substance used on them.
A percentage of the fat transferred
will be reabsorbed by the body, therefore, to achieve a
good result the doctor has to over-correct the area. This
will result in obvious swelling for a few weeks and quite
possibly some bruising. The patient will requires some
down time, in terms of work or social commitments, until
the area has settled.
30% of the fat will disappear in the first 2 - 3 days, another
30-40% will disappear in the next few months and about 30%
will stay permanently. The other factor to take into consideration
is that the area from where the fat is taken (the donor site)
will be tender and bruised for several days.
Fat injected into the upper lip
will certainly plump up the lip, but will not result in
a clearly defined border. If this is the look you want
then you may have to consider another form of injectable,
such as collagen.
The fat transfer procedure may need to
be repeated several times to achieve the desired result.
It will not work for everybody and there is no way of predicting
this ahead of time.
Skin Conditions
Vascular
Conditions
This is a broad group of conditions
include vascular birth marks such as port wine stains,
facial telangiectasias, acne rosacea, poikiloderma of civatte
and leg veins.
At Adelaide Plastic Surgery Associates,
we have a Copper Bromide Laser (Dual Yellow - Norseld)
and a
Flash Pumped Pulsed Dye Laser (V-Beam
- Candela). Your doctor will advise which laser will suit
the condition you have. We also have an Intense Pulsed
Light/Radio-frequency machine (Aurora - Incision) and a
Diode/Radio-frequency machine (Polaris - Incision)
Vascular Birthmarks
There are many types of vascular
birthmarks but most are treatable with the V-Beam laser.
It is usual to require several treatments with approximately
6 weeks between treatments. In most cases, a Medicare rebate
applies for this treatment.
There may be some bruising and swelling
after a treatment with the V-Beam laser but this usually
only lasts a few days. Treatment is quickly and easily
performed with minimal discomfit.
Visible blood vessels on the face
are unsightly and easily treated with the Copper Bromide
Laser. These are often caused by genetics, sun exposure,
trauma such as skin cancers surgery and acne and conditions
such as rosacea.
They may become more apparent with
triggers such as alcohol, heat, caffeine and emotion. They
are often unsightly and associated with the stigma of being
a "drinker". Usually, only a couple of treatments
will clear these blood vessels. With time they do recur
and maintenance treatment may be necessary. In some cases,
a medical rebate may apply to this treatment.
Acne Rosacea
This is a condition that causes
redness, flushing and often facial rash. It is socially
disabling for many people. In most cases, treatment with
the V-Beam laser reduced redness and flushing significantly.
Some people also require topical or oral antibiotics. Several
treatments are usually required and in most cases, a medical
rebate applies.
Poikiloderma of Civatte
This is discoloration of the neck
and chest due to sun damage. It is usually demarcated from
normal skin along the neckline of clothing. It may consist
of redness, brown pigmentation and textural change of the
skin. The red component is treatable with the V-beam laser.
If there is also brown pigment, Intense Pulsed Light may
treat both the red and brown pigmentation. The textural
change is difficult to reverse with any treatment.
Leg Veins
Pigmentation Disorders
Disorders of pigmentation include
brown (melanocytic) birthmarks, melasma and chloasma, post-inflammatory
hyper-pigmentation, solar and actinic lentigines and freckles.
The common feature with all of these conditions is an excess
of the skin pigment melanin.
In many cases, the excess pigmentation
may be treatable with the Nd:YAG (Neodynium:Yttrium Aluminium
Garnet) Laser. In some cases, a medical rebate applies.
Other treatments for excess pigmentation
include bleaching creams, chemical peels and intense pulsed
light treatments.
Scars
Hypertrophic and Keloid Scars
These scars are difficult to remove
completely but improvement can be achieved with a combination
of treatments including vascular lasers for colour and
intra-lesional steroid and 5-fluorouracil (5-FU) injections.
Compression therapy with tapes or silicon gel may also
be used.
Acne Scars
Scars from acne can present in many
ways with some being raised and red (see Hypertrophic/Keloid
Scars) and others and pitted or indented. They are often
broad based or narrow and deep (ice-pick scars) and cover
large areas of the face, chest and back.
Usually a combination of treatments
will be required including laser skin resurfacing, facelift,
subcision, excision, punch grafting as well as chemical
peels, injectable fillers, laser and light based treatments.
A program will be tailored to your particular type of scarring.
Tattoos
Traumatic, medical, amateur and
body art tattoos can be treated with lasers to reduce or
remove the inks or particles in the skin. At Adelaide Plastic
Surgery Associates, we use both the Nd:YAG laser and the
ruby laser for treating tattoos.
Some inks are better treated than
others with black ink being the most successful. Green
and light blue inks are difficult to remove completely
and may leave some residual pigmentation or colour. Tattoos
require several treatments over 1-2 years. Further information
will be provided at your consultation.
Sun Damage and Skin Cancers
There is a broad spectrum of sun
damaged skin and skin cancers. Some require surgical treatment
(see skin tumours in reconstructive surgery section) and
others are suitable for non-surgical treatment. Topical
agents, photodynamic therapy (PDT), laser ablation and
cryotherapy are just some of the treatments that can be
used. Your doctor will advise you of the best treatment
method for you.
Birthmarks
Birthmarks may be vascular (red)
or melanocytic (brown). Some contain hair or other features.
Your doctor will advise you of the most appropriate treatment.
Most can be improved with laser therapy but some birthmarks
require surgical treatment.
Wrinkles and Rejuvenation
There are many non-surgical treatments
available for the reduction of lines and wrinkles and for
an overall improval in appearance.
Dermal filling agents and muscle
relaxing injections are available at Adelaide Plastic Surgery
Associates as well as intense pulsed light, non-ablative
wrinkle reduction, chemical peels and skin
care products as well as the full
range of plastic and cosmetic surgery.
Dermal fillers include Collagen, Hylaform,
Sculptra (formerly New-Fill) and Restylane Muscle relaxing
injections are also used to treat frown-lines, smile-lines,
crows-feet, forehead-lines, nasal-scrunch lines as well
as manipulating eyebrow height and shape.
Acne
Adelaide
Acne Clinic
Acne is a problem that plagues so many,
from early teens to ongoing adult-acne. There are many
treatments available from creams and cleansers to prescription
medications. Unfortunately these treatments have varying
results and some have serious side effects. Some of these
have been highlighted in the media (Roaccutane)
This DRUG FREE treatment is a complete
program to treat active acne on many different fronts.
There are: products to cleanse the skin; Laser treatments
to reduce the size of over-active sebaceous glands and
Phototherapy for the elimination of the bacterial component.
The treatment requires commitment, but in approximately
one month, it can effectively eliminate up to 70% of inflammatory
skin pimples. You will be receiving treatment to both the
cause and the condition.
Skin management and maintenance is required to obtain the
maximum benefit. It is necessary for you to follow the program
regime between sessions and after the treatment is completed,
to reduce the possibility of new acne occurring.
Your first visit will be with an
Acne Consultant who will assess your acne and include a
history and assessment of your skin. They will then go
through and explain the program in detail and demonstrate
the treatment machines. You will have all your questions
answered so that you can make an informed decision to progress
with the treatment.
The treatment cycle is generally completed
in 4 to 6 weeks using a combination of therapies. This
thorough, comprehensive acne treatment reduces the chance
of acne related scaring and long-term skin damage. The
treatments are comfortable and cause no collateral skin
damage and are well tolerated by sensitive skin types.
Tumours
Benign
tumours
The majority of skin moles and growths
are harmless, hence being mainly of cosmetic concern. Nevertheless,
the public awareness campaign about skin cancer risk motivates
people to have many such moles removed for peace of mind.
Thin or early growths may be removed by laser without causing
a scar. Larger, more advanced growths may need to be surgically
excised, consequently leaving a fine scar. We use the Sciton
(Erbium YAG) laser for ablation of benign (and selected
superficial skin cancers).
The Sciton is an extremely accurate ablative laser, that
produces very little collateral tissue injury, hence minimizing
complications such as scarring and hyper or hypo-pigmentation.
We do not use chemical or electrical cautery, as these
procedures give less control to the operator; consequently
they have a higher complication risk profile.
Malignant Tumors
Skin
Cancers
Australians have one of the highest
rates of skin cancer in the world. This is due to our warm
climate and the fact that many of us have fair skin, which
is not suited to Australian conditions. Adding to this
is our love of the great outdoors, where many of our activities
are based. Ultraviolet radiation causes skin cancer by
not only damaging cells in the skin, but also by depressing
our immune system so that it is less able to destroy cancerous
cells. We accumulate damage to our cells throughout our
lifetime. It is never too late to start protecting our
skin with a 30+ broad spectrum sunscreen, protective clothing
and hats. Most skin cancers are curable, however early
detection is important. Basal cell carcinomas (BCCs) are
the most common skin cancer.
They usually occur on sun-exposed areas and grow slowly
over time. They almost never spread elsewhere, but left
untreated they will continue to grow, potentially making
treatment more difficult. Squamous cell carcinomas (SCCs)
are also very common in Australia. They can grow quickly
and need to be detected early as they can occasionally
spread if treated too late. Melanomas are another form
of skin cancer that arise from our pigment producing cells
(melanocytes). They are not as common as BCCs or SCCs,
however they are potentially fatal and early detection
is crucial. They can arise from moles, but often develop
on normal skin. Melanomas, unlike BCCs and SCCs, occur
not infrequently in younger people. The risk factors for
developing melanomas include a family history of melanoma,
excessive sun exposure, sunburn (particularly when young)
and having many moles. Change in a mole is an important
clue as is an irregular outline or colour. It is important
for Australians to have regular skin checks to improve
the chances of detecting early skin cancers. We have doctors
that offer full skin examinations for skin cancers and
are experienced in treating them. Depending on the type
of skin cancer, we offer topical treatments (creams), photodynamic
(cream followed by intense red light), laser therapy and
surgery. We also have treatments for other sun-induced
skin problems, such as sun spots, increased pigmentation,
prominent capillaries and wrinkles.
Photodynamic Therapy
(A
new treatment modality)
The treatment of skin cancer and pre-malignant
skin lesions has traditionally relied on surgical excision.
This remains the mainstay of treatment. The benefits are
that the lesion is completely excised and there is histological
confirmation of that fact. The benefits of a non-surgical
solution are obvious, avoiding surgery, scarring and possible
disfigurement. However one must always remember that when
you are dealing with a malignancy these goals must always
be secondary to the primary aim of cure. There are many
non-surgical options for the treatment of skin cancer and
pre-malignant skin lesions. These include
Cryotherapy
Laser ablation
Topical 5-fluorouracil
Imiqamod
Intralesional interferon
Photodynamic therapy has a number of
advantages in the treatment of skin cancer and pre-malignant
skin lesions. It is a one-stage treatment with proven efficacy
and may be used to treat a large area in a single setting.
The process is as follows.
Aminolevulinic acid (an anti-neoplastic agent) is applied
to the lesion. This is absorbed by the
neoplastic (cancerous) cells.
The aminolevelinic acid cream is covered and left in
contact with the lesion for 2-4 hours.
The lesion is then uncovered and excess cream wiped
away.
Red light is then applied to the lesion for 20 minutes.
This results in cell damage that specifically targets
the neoplastic cells, leaving the normal healthy cells
unharmed.
The treatment period when the light
is applied may be uncomfortable. Following the treatment
there will be redness, inflammation, and crusting of the
area for 1-2 weeks. Photodynamic therapy is only appropriate
for selected skin cancer and pre-malignant skin lesions.